We are seeking a detail-oriented and experienced Risk Adjustment Coder to join our dynamic team. The ideal candidate will be responsible for ensuring the accuracy and completeness of clinical data used to support risk adjustment coding for our Medicare plan.
You will work closely with healthcare providers and clinical teams to identify and mitigate documentation gaps, supporting the organization's mission to provide exceptional care to its members.
Responsibilities
- Conduct thorough reviews of medical records to ensure accurate coding and complete documentation for risk adjustment purposes.
- Apply ICD-10-CM and HCC coding guidelines to properly document diagnoses and procedures for Medicare beneficiaries.
- Collaborate with clinical staff to educate and improve documentation practices that support accurate risk adjustment coding.
- Identify opportunities for improvement in documentation and coding processes and participate in quality improvement initiatives.
- Maintain current knowledge of risk adjustment methodologies, coding guidelines, and Medicare regulations.
- Generate coding reports and provide feedback to medical staff regarding documentation compliance.
- Participate in training sessions and continuous education to stay updated on industry changes.
- Perform other duties as assigned.
Requirements & Qualifications
Knowledge, Skills, and Abilities
- Ability to read and interpret documents and identify areas of coding gaps.
- Ability to speak effectively with physicians and employees of the agency.
- Ability to identify areas of over- or under-utilization and work with teams and physician groups to develop processes to avoid them.
- Ability to work with the team on developing processes for right-coding, appropriate utilization, and closing gaps in care.
Location
New York, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
4 months ago